Pandemic And The Post-American World

The other day, French President Emmanuel Macron told the French people “we are at war” as he announced emergency measures to deal with the COVID-19 pandemic. This is a war that will probably be fought in every country, in every corner of the globe. It may very well end up with millions dead and many more millions requiring extensive medical treatment. This war may be quick, a blitzkreig that lasts only a few months, as testing and social distancing prove effective at slowing down and containing the pandemic. On the other hand, there are increasing indications that there is no immunity from the virus, leaving the only sure end to the pandemic to a vaccine which is likely 18 months away. If we see a renewed spike in infections in China and South Korea as those countries return to something near normal, that would indicate the world is in for a prolonged crisis.

Compared to other advanced countries, America seems uniquely unprepared for this kind of war, a result of forty years of Republican political dominance that focused on outsourcing essential government functions to their crony capitalist patrons and refusing to build the social safety net that every other advanced industrialized country provides, while gutting the already pathetic one already in place. It is a result of a Republican party focused on rewarding shareholders at the expense of workers, believing that the only legitimate investment is one taken on by business. It is a result of a Republican party whose sole policy priorities are tax cuts for the rich, spending cuts for the poor, and rigging the system for their own continued power. It is a result of a Republican party that denies science and relies instead on propaganda, creating an epistemic bubble that allowed an unqualified, criminally corrupt, multiply-bankrupted game show host to become President. It is a result of an electoral system that seems designed to prevent people from voting and a political system that has created minority rule.

As the country heads into the teeth of this pandemic, we still have over 27 million Americans without health insurance, over 9% of the population. That is likley to increase substantially as workers lose their jobs and the health care coverage that goes with it. Even now, at this very moment, the Trump administration is in court trying to get the ACA ruled unconstitutional, which would effectively double the number of people without health insurance. There are states that still refuse federal money that would pay for virtually all the cost of Medicaid expansion, resulting in over 15,000 unnecessary deaths in a four year period. Trump has now provided states with the option of converting Medicaid to a block grant, which studies show will reduce services, and is now promising further cuts to Medicare and Medicaid.

There is no federally mandated sick leave in the US, although many states do require it. But the length of sick leave required and offered is pathetic compared to other industrialized economies, usually around 7 days per year. At least 25% of the population gets no paid sick leave at all, but that number varies dramatically from state to state. For instance, in Michigan, 55% of workers receive no paid sick leave. In 2018, there was a successful effort to get paid sick leave and a $12 minimum wage on the ballot. The Republican legislature sabotaged this effort by passing bills to put those proposals into law, which blocked those questions from appearing on the ballot. After the November election, the legislature then cynically and brazenly rolled back the laws it had passed before the election during its lame duck session. Such is the extent to which Republicans will go in order to deny sick leave, a living wage, and health coverage to their own fellow citizens. Finally, in states that do require sick leave, the vast majority of those who receive it are high wage workers who probably have more resources to weather the economic disruption of the pandemic than their low wage counterparts.

The US spends far more money per capita for healthcare than any other country and yet provides less access to health care resources and outcomes that are merely average. The US has 2 fewer practicing nurses and one fewer acute care hospital bed per 1,000 people than the OECD average, as well as one less physician per 2,000 people. We also have far fewer regular hospital beds per capita than the average advanced country, just 2.4 compared to, say, South Korea’s 12.2. Public health spending on prevention and preparedness is a paltry 2.5% of all health spending, despite studies showing that each dollar spent would save $14 in the future. Remarkably, but perhaps unsurprisingly, GOP Senator Susan Collins used the stimulus package passed in 2009 as a response to financial crisis as an opportunity to strip nearly $900 million from pandemic preparedness. Even marginally better preparedness for the pandemic here in the US would have saved not only millions of dollars but also thousands of lives.

In 2019, Trump’s own HHS ran a pandemic simulation that highlighted “just how underfunded, underprepared and uncoordinated the federal government would be for a life-or-death battle with a virus for which no treatment existed”. It showed that the US “did not have the means to quickly manufacture more essential medical equipment, supplies and medicines, from antiviral medications to needles, syringes, N95 respirators and ventilators”. The report containing the results of this test seems to have been effectively buried and it seems clear that senior officials were either unaware or ignored its conclusions.

Yes, this pandemic will overwhelm most governments’ short term abilities and resources, but Trump’s unfitness for the job and inability to actually lead has made our situation far worse in ways that are too innumerable to document. It is clear that the systems designed to deal with a serious biological attack, manmade or natural, were woefully insufficient. The US and South Korea both discovered their first COVID-19 cases on the same day. Since that time, South Korea has been able to deliver over 290,000 tests; the US has performed around 60,000. The government is sending out masks that have expired and hospitals are quickly running out of protective gear. The lack of testing and protective gear means that medical workers are flying blind, putting their lives and the lives of people they treat in danger. That also applies to all those supposedly “low-skilled” workers who provide basic services like sanitation workers, mail men and women, delivery workers, bank tellers, and those all along the food supply chain, from the farms to the stores. The lack of testing means that we have no idea where to focus resources or ability to get an accurate handle on how deadly the virus is.

Max Boot, of all people, finally states what has been obvious to any close observer of US politics for years. Says Boot, “We should not be especially surprised by our failure at pandemic-fighting, because if we are being honest with ourselves, we would have to admit that the United States has long been failing. We remain one of the richest countries in the world, but by international standards we look more like a Third World nation…we lag in almost every measure of societal well-being among the wealthy nations (now 36) of the Organization for Economic Cooperation and Development (OECD). As of 2016, we had the second-highest poverty rate, the highest level of income inequality and the highest level of obesity. We spent the most on education but produced less-than-average results. We were also below average on renewable energy, infrastructure investment and voter turnout…One area where we do lead is gun violence. Our homicide rate is nearly 50 percent above the OECD average…Child mortality in the United States is the highest in the OECD, and life expectancy is below average.” We are a first world economic and military power with a third world society.

Boot lays this failure directly at the feet of the Republican party, saying, “President Trump has exacerbated the problem, but he didn’t start it. He is himself the product of decades of right-wing revolt against government and increasingly against reason itself. America is unusual in having a major party — and a major television network — devoted to climate denialism and protecting the ‘right’ of everyone to own an assault rifle…The Republicans’ decades-long demonization of government has consequences.” And thousands will die as part of those consequences.

The COVID-19 epidemic has exposed America as an emperor with no clothes. In past crises, the world has looked to this country for aid and leadership. In this crisis, we can provide neither; we can’t even provide those to our own people.. Instead, we find Trump literally trying to purchase a vaccine for the virus for exclusive use by the US from a German company. We have been reduced to flying in test kits from Italy. It is China that is sending aid in the form of two million surgical masks, 200,000 N95 masks, and 50,000 test kits to the EU. It is China that is sending 300 intensive care doctors to Italy. The Serbian President has declared, “Our only hope is that China and Chinese brothers will help us. By now, you all understood that European solidarity does not exist. That was a fairy tale on paper. I believe in my brother and friend Xi Jinping, and I believe in Chinese help”. As Julia Davis notes, “the Trump team’s utter failure to implement obvious and needed actions that every other nation did…undermined American power and reputation in a way never before experienced”. America First increasingly has come to mean America Alone. American “exceptionalism” has come to represent extraordinary failure.

World War I saw the end of four aging empires, the Ottoman, Austro-Hungarian, German, and Romanov. World War II saw the end of imperial Japan and precipitated the demise of the British empire. It now seems remarkably possible that the COVID-19 pandemic may also signal a similar decline in American hegemony and influence. Like all those aforementioned powers, there were already signs of weakness and decay, combined with enormous hubris and overestimation of power, that the immediate crisis exacerbated. America’s blood and treasure were wasted in the sands of Iraq and the mountains of Afghanistan. Its purported commitment to human rights died in the prisons of Abu Ghraib and Guantanamo. Its alliances have been subverted by an ignorant dolt of a President and its capabilities diminished by forty years of Republican demonization of the actual functions of government. America will still wield enormous economic and military power but its ability to determine or even shape the international order will be severely compromised. The COVID-19 pandemic is the signal of a post-American world. If America hopes to rebuild its society and restore its place in the world, it must become a post-Republican country.